STUDY QUIZ 2 Flashcards by Unknown Unknown

Which of the following occurs first in dental biofilm formation?
A. Matrix formation
B. Pellicle formation
C. Biofilm growth
D. Bacterial multiplication and colonization

B. Pellicle formation

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How long after tooth cleaning does the pellicle begin to form?
A. Instantly
B. Within minutes
C. After 24 hours
D. After 2 days

B. Within minutes

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The acquired pellicle is primarily composed of:
A. Proteins and carbohydrates
B. Lipids only
C. Calcium and phosphate
D. Bacterial endotoxins

A. Proteins and carbohydrates

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Which statement best describes the function of the acquired pellicle?
A. Increases enamel permeability
B. Protects enamel and aids bacterial adherence
C. Provides energy to bacteria
D. Decreases bacterial attachment

B. Protects enamel and aids bacterial adherence

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During which stage do planktonic (free-floating) bacterial cells attach to the pellicle and form microcolonies?
A. Pellicle formation
B. Bacterial multiplication and colonization
C. Matrix formation
D. Maturation

B. Bacterial multiplication and colonization

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What is secreted during matrix formation to help stabilize bacterial colonies?
A. Enzymes
B. EPS (extracellular polymeric substances)
C. Calcium ions
D. Collagen fibers

B. EPS (extracellular polymeric substances)

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In the biofilm growth stage, bacteria begin to:
A. Form new pellicle
B. Increase mass and communicate via chemical signals
C. Die off
D. Detach and float away

B. Increase mass and communicate via chemical signals

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During maturation, bacterial colonies:
A. Release planktonic cells to colonize new areas
B. Form initial attachment
C. Are destroyed by saliva
D. Form calculus immediately

A. Release planktonic cells to colonize new areas

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The first microorganisms to colonize the pellicle are:
A. Actinomyces species
B. Streptococcus sanguinis and Streptococcus mutans
C. Lactobacillus species
D. Spirochetes

B. Streptococcus sanguinis and Streptococcus mutans

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Gram-positive cocci appear in the biofilm within:
A. 1–2 days
B. 5–7 days
C. 14 days
D. 21 days

A. 1–2 days

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Gingivitis caused by undisturbed biofilm typically develops in:
A. 5–7 days
B. 10–14 days
C. 14–21 days
D. 30 days

C. 14–21 days

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As biofilm matures, it becomes:
A. Gram-positive and aerobic
B. Gram-negative and anaerobic
C. Gram-positive and spirochete-rich
D. Sterile

B. Gram-negative and anaerobic

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Which of the following is inorganic in biofilm?
A. Proteins and lipids
B. Calcium and phosphorus
C. Dextran and levan
D. EPS

B. Calcium and phosphorus

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The organic components of biofilm include:
A. Calcium and fluoride
B. Carbohydrates, proteins, lipids
C. Water and ions
D. Sulfur compounds

B. Carbohydrates, proteins, lipids

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The matrix of biofilm (EPS) provides what main function?
A. Source of minerals for remineralization
B. Sticky, protective film that shelters bacteria
C. Enamel strengthening
D. Fluoride absorption

B. Sticky, protective film that shelters bacteria

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The acquired pellicle can be described as:
A. Hard, calcified layer of bacteria
B. Film of proteins and carbohydrates on oral surfaces
C. Mineralized biofilm
D. Cottage cheese–like material

B. Film of proteins and carbohydrates on oral surfaces

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Dental biofilm is also known as:
A. Calculus
B. Plaque
C. Materia alba
D. Food debris

B. Plaque

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The first step in calculus formation is:
A. Biofilm maturation
B. Pellicle formation
C. Mineralization
D. EPS secretion

B. Pellicle formation

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Mineralization begins how long after biofilm forms?
A. 1–2 hours
B. 24–72 hours
C. 7–10 days
D. 14 days

B. 24–72 hours

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Full mineralization of calculus typically occurs within:
A. 5–7 days
B. 10–20 days
C. 21–30 days
D. 1 month

B. 10–20 days

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The major minerals in calculus include:
A. Sodium and sulfur
B. Calcium, phosphorus, carbonate, magnesium, potassium, fluoride
C. Iron and zinc
D. Collagen and protein

B. Calcium, phosphorus, carbonate, magnesium, potassium, fluoride

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The critical pH for enamel demineralization is:
A. 6.5
B. 5.5
C. 4.5
D. 7.0

B. 5.5

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The critical pH for dentin/cementum demineralization is:
A. 5.5
B. 6.2–6.7
C. 7.0
D. 4.8

B. 6.2–6.7

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After eating fermentable carbohydrates, the pH remains acidic for approximately:
A. 5 minutes
B. 10–15 minutes
C. 20–40 minutes
D. 1 hour

C. 20–40 minutes

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Which factor contributes most to demineralization and caries? A. High calcium intake B. Frequent sugar exposure and prolonged low pH C. Frequent toothbrushing D. High saliva pH

B. Frequent sugar exposure and prolonged low pH

Remineralization occurs when: A. Bacteria produce more acid B. Calcium, phosphate, and fluoride repair enamel crystals C. EPS thickens the matrix D. Saliva decreases

B. Calcium, phosphate, and fluoride repair enamel crystals

The first stage of dental caries is: A. Cavitation B. Demineralization C. Dentin invasion D. White spot lesion

B. Demineralization

Which organisms are most associated with root caries? A. Lactobacillus species B. Actinomyces viscosus and Actinomyces naeslundii C. Streptococcus sobrinus D. Spirochetes

B. Actinomyces viscosus and Actinomyces naeslundii

Class I caries occur on: A. Cervical third of facial or lingual surfaces B. Proximal surfaces of posterior teeth C. Pits and fissures of occlusal or lingual anterior surfaces D. Incisal edges

C. Pits and fissures of occlusal or lingual anterior surfaces

Class II caries are found: A. On proximal surfaces of anterior teeth without incisal edge involvement B. On proximal surfaces of posterior teeth C. On incisal edges or cusp tips D. On root surfaces

B. On proximal surfaces of posterior teeth

Class III lesions occur: A. On proximal surfaces of anterior teeth without incisal involvement B. On posterior occlusal surfaces C. On cusp tips D. On gingival third of teeth

A. On proximal surfaces of anterior teeth without incisal involvement

Class IV lesions involve: A. Pits and fissures B. Proximal surfaces of anterior teeth including incisal edge C. Posterior proximal surfaces D. Root caries

B. Proximal surfaces of anterior teeth including incisal edge

Class V lesions are located: A. At the cervical/gingival third of facial or lingual surfaces B. On incisal edges C. On pits and fissures D. On proximal surfaces of molars

A. At the cervical/gingival third of facial or lingual surfaces

Class VI lesions are found: A. On proximal surfaces of posterior teeth B. On incisal edges or cusp tips C. On root surfaces D. On gingival margins

B. On incisal edges or cusp tips

DMFT stands for: A. Decayed, Missing, Filled Teeth B. Dental Management Frequency Test C. Dentin Mineralization Fluoride Test D. Decayed Mineral Free Teeth

A. Decayed, Missing, Filled Teeth

The DMFT index measures: A. Calculus formation B. Total lifetime caries experience in permanent teeth C. Fluoride exposure D. Gingival bleeding

B. Total lifetime caries experience in permanent teeth

CAMBRA stands for: A. Caries Management by Risk Assessment B. Calcium and Mineral Balance Risk Analysis C. Caries and Mouth Bacteria Rate Assessment D. Clinical Activity Monitoring by Risk Appraisal

A. Caries Management by Risk Assessment

The main purpose of CAMBRA is to: A. Remove calculus B. Identify risk and balance protective vs. pathological factors C. Classify caries lesions D. Measure fluoride concentration

B. Identify risk and balance protective vs. pathological factors

A low caries risk patient’s main intervention is: A. Fluoride varnish and chlorhexidine rinse B. Sealants and frequent recall C. Preventive education and routine recare D. Antibiotic therapy

C. Preventive education and routine recare

Moderate risk caries management includes: A. Sealants, fluoride, and risk factor reduction B. Only preventive education C. Extraction of teeth D. Avoidance of fluoride

A. Sealants, fluoride, and risk factor reduction

For high-risk caries patients, recommended interventions are: A. Chlorhexidine rinse, fluoride varnish, dietary change, frequent recall B. No fluoride C. Routine annual cleaning only D. Mouth rinse only

A. Chlorhexidine rinse, fluoride varnish, dietary change, frequent recall

Pellicle Formation – thin acellular film forms minutes after cleaning.

stage 1 biofilm

Bacterial Multiplication & Colonization – planktonic cells attach, forming microcolonies.

stage 2 biofilm

Matrix Formation – bacteria secrete EPS (extracellular polymeric substance).

stage 3 biofilm

Biofilm Growth – increased mass and communication between cells.

stage 4 biofilm

Maturation – colonies release planktonic cells to colonize new areas.

stage 5 biofilm

When do gram positive cocci enter the bacterial biofilm

First microorganisms to colonize the pellicle in early biofilm formation. Appear within the first 1–2 days; mostly Streptococcus sanguinis and Streptococcus mutans.

How long does it take for biofilm induced gingivitis to develop

Gingivitis develops within 14–21 days of undisturbed biofilm accumulation. By this stage, biofilm becomes gram-negative, anaerobic, and spirochete-rich

Composition of biofilm calcium, phosphorus, magnesium, fluoride.

inorganic

Composition of biofilm carbohydrates (dextran, levan), proteins, lipids.

organic

a film made up of proteins and carbohydrates that attach itself to the hard and soft surfaces of the mouth.

acquired pellicle

plaque. It is made up of microorganisms that build colonies on the teeth.

biofilm

a white buildup that attaches to the tooth surface that resembles cottage cheese. It can be removed by brushing.

materia alba

pieces of food that get stuck in the teeth.

food debris

Mineralized biofilm; rough surface retains more plaque

calculus

Acquired pellicle formation what time forms, function, and type

Forms within minutes after tooth cleaning. Functions: protects enamel, aids bacterial adherence. Types: Supragingival: clear, translucent, visible when stained. Subgingival: continuous with surface pellicle; embedded in tooth structure. Removed by abrasive dentifrices or acidic foods.

calculus steps

Pellicle formation Biofilm maturation Mineralization – deposition of calcium and phosphate crystals into biofilm matrix.

when does calculus begin

Begins 24–72 hours after biofilm formation;

when is complete mineralization for calculus

10–20 days for complete mineralization.

calcium, phosphorus, carbonate, magnesium, potassium, fluoride

calculus makeup

critical pH for enamel demineralization

5.5

critical pH for dentin demineralization

~6.2–6.7

Natural repair process using calcium, phosphate, and fluoride. Saliva buffers acids and supplies minerals. Fluoride promotes remineralization by forming fluorapatite crystals that resist acid dissolution

remineralization

after eating cariogenic food what happens to ph

After you eat cariogenic foods, the pH in your mouth drops significantly, becoming more acidic

white, without a clear shape, form bridge, over margin, based on anatomy, hard, diet and smoke, coronal to margin of gingiva, facial of max molars and lingual man anterior

supragingival biofilm

light to dark brown, conforms to root surface, crusty, ringlike, thin, finger-like, islands, harder, bacterial load and disease, apical to margin of gingiva, heaviest on proximal surfaces

subgingival biofilm

Demineralization: acids dissolve calcium and phosphate from enamel.

step 1 caries

Initial lesion: subsurface white spot (non-cavitated).

step 2 caries

Progression: bacteria invade dentin via DEJ.

step 3 caries

Cavitation: irreversible breakdown of surface

step 4 caries

Motile, gram-negative organisms located between the two layers of attached biofilm, found in sulcus fluid.

Unattached Biofilm

A type of biofilm that is attached to tooth surfaces, consisting of densely packed microorganisms over pellicle.

Subgingival Dental Biofilm

Dental Biofilm Changes Cocci dominate and increasing number of gram positive filamentous forms and slender rods are seen on the surface of the cocci colonies Filamentous forms grow into cocci layer and replace many cocci

days 2-4

Filaments continue to increase in numbers, mixed flora begins to appear with rods, filamentous forms, and fusobacteria Biofilm near gingial margin thickens; mature flora develops gram- negative spriochetes and vibrios Biofilm spreads coronally- new biofilm has cocci forms

days 4-7

Vibrios and spirochetes appear; white blood cells increase Signs of gingival inflammation and becoming observable

days 7-14

Acute gingivitis is clinically evident More gram-negative anaerobis organisms appear

14-21 days

pH of biofilm is lowered, and ____ are required for the pH to return to a normal level if the biofilm is left undisturbed

1 to 2 hours

biofilm composed of __% water and __ % organic/inorganic

80 and 20

When does calcification happen?

Usually 10-14 days

Loosely attached to the lining of sulcus epithelium, containing gram-negative microorganisms and leukocytes.

Epithelium-associated Biofilm

STUDY QUIZ 2 Flashcards

(80 cards)